From Alternative Medicine a Definitive Guide to the Wellness Inventory – An Interview with Pioneering Entrepreneur Jim Strohecker

Summary:
One of the rarely sung, significant influencers of our field is entrepreneur Jim Strohecker. Some 18 years ago he was executive editor of the 1100 page text, Alternative Medicine: The Definitive Guide which involved nearly 400 practitioners and organizations. In the mid-1990s, Strohecker co-founded HealthWorld Online, the first aggregator of wellness and alternative medicine-oriented content, services and professionals on the emerging web. More recently, he has not only re-purposed that site as Healthy.net, he also brought forward the work of wellness pioneer John Travis, MD, MPH. He promotes Travis’ visionary Wellness Inventory through an online program for integrative medicine centers, hospitals, corporations, spas and individuals, together with a related coach certification training. In this Integrator interview, Strohecker’s comments say much about the history of the integrative practice movement of the last 20 years, and its relationship with the broader wellness effort. Enjoy the learning, and for some of you, the recollections!

Jim Strohecker: Two decades of enterpreneurial action in alternative medicine and wellness

I recently had a catch-up call with Jim Strohecker, CEO of HealthWorld Online. His internet portal (www.healthy.net) re-publishes Integrator articles and sends links to the over 100,000 individuals on his newsletter list. Our conversation shifted from particulars of our relationship to our shared interest in promoting a wellness movement in the United States. He ventured that the U.S. needs an initiative on the scale of the Manhattan project from the 1940s. We spoke of the exciting potential of the new Bravewell-IOM-AARP partnership. Our exchange led to this column: Rocket Science, Manhattan Projects and a Healthy Nation Partnership.

While we spoke, I reflected on Strohecker’s many, quiet contributions
to this field since he and I first met in the early 1990s. First there was the profound influence of the 1100 page, pioneering Alternative Medicine: The Definitive Guide for which he served as executive editor. Strohecker and his staff personally worked with nearly 400 practitioners and organizations across the alternative healthcare fields to build that massive text. (“Integrative medicine” didn”t yet exist and “complementary medicine” had not been imported from England.) Then came Strohecker”s early jump into the internet with the launch of HealthWorld Online. More recently he has focused on what he calls “bringing back a whole person perspective” on wellness. His work is centered on the promotion of the online Wellness Inventory developed by pioneer John Travis, MD, MPH after completing his residency at Johns Hopkins in the mid-1970s.

The arc of action and influence of Strohecker”s professional life led me to send
him a handful of open-ended questions. I asked him to be brief, caveating this
with recognition of my own shortcomings in that department. Strohecker sent
back this handiwork from a good day of self-reflection and history telling.
Take a breath and enjoy this read. Strohecker”s story elucidates significant
aspects of our trajectory toward health and wellness.

Integrator: It’s been nearly 2 decades since
Alternative Medicine: The Definitive Guide was published. Those 1100 and some
pages gave the consumer movement for alternative medicine “drop value” back
then – hard covered, weighty and un-deniable if not exactly legitimate. In some
respect it was a first consortium effort with all those contributors. What was
it like to be pulling that book together. What was it’s reception, it’s value?

Strohecker: When we started working on the book in 1991, the
public as a whole was still very skeptical of “alternative medicine”, the
medical establishment was overly hostile and actively targeting “alternative”
practitioners, and the media tended to belittle, ridicule, and marginalize
anything outside of mainstream medicine. In short, it was a very challenging
time and environment for those practitioners who had the courage to follow their
convictions as to what constituted “best practices”.

Nearly 400 practitioners and organizations contributed

Our intent in creating the book was fourfold: to
define, clarify, and legitimize alternative medicine by synthesizing, in one
volume, knowledge from nearly 400 experts, dozens of professional associations,
and the leading available research; to provide consumers with direct access to
this knowledge as well as referral to practitioners; to create a bridge for
health professionals to be introduced to the field; and to provide a
substantive resource for policy makers who could no longer dismiss alternative
medicine as a fringe phenomenon.

The
creation of the book was a passionate, collaborative journey with the
participating health practitioners and associations, to promote medical freedom
and to give the various systems of medicine and modalities comprising
alternative medicine a seat at the healthcare table. Practitioners were
grateful and happy to participate in a project that sought to give them a voice
in a potentially historic project. And, it was an adventure with plenty of
drama with many participating practitioners being harassed by their state
medical boards and even losing their licenses during the book’s creation. Some
doctors chose to speak off the record as they didn’t want to be on the radar
screen of the FDA or state medical boards.

The most famous raid, the FDA raid of Dr.
Jonathan Wright’s clinic in Kent, Washington, on May 6, 1992, when FDA agents
and 10 police officers, broke down the clinic’s door and entered with
flak jackets and guns drawn, to the horror of the staff and patients, futher
galvanized our mission. The opening chapter, “Medical Freeom and the Politics
of Health Care” profiled Dr. Wright’s case, and other abuses by the FDA, and
ended with an open letter to President Clinton and the First Lady about
including forms of effective, low-cost alternative medicine and promoting
medical freedom in their health reform package.





By the time the book was completed it had grown
to nearly 1100 pages, and with the challenges of its’ interactive layout, it
was clear that it wouldn’t possible to go through a conventional publisher, so
created our own publishing company, Future Medicine Publishing. The last major
hurdle was creating the book’s title. This was my first experience with the
challenges of attempting to name this great collection of traditional systems
of medicine and therapies and self-care practices, both ancient and modern.
After considering Holistic Medicine, Complementary Medicine (this term was
really only being used in the UK in the early 1990s), and other names, we chose
“Alternative Medicine”, as is the title best represented its relation to
prevailing mainstream medicine, and how to best position it with the public –
as an alternative. The Office of Alternative Medicine had also named its first
director the previous year.

Our
next step was to devise our own conventional and guerilla marketing strategy to
get it in front of as many consumers, health practitioners, media, and
lawmakers as possible with our 6 pound hardcover book retailing at $59.95 and
taking on the established order. Our first step, once the books arrived from
the printer, was to hand deliver a copy of the book to all 535 members of
Congress. The book was very well received by the public, health practitioners
and surprisingly, the press, starting with a glowing article about the book in
the Washington Post. Soon the book was in Costco, Sams, and bookstores
nationwide, and was being sold in the office of health practitioners through a
special program and an infomercial. Many consumers and practitioners felt
validated by something they could show to the friends, family or peers to show
that there was some real substance to the “fringe” healthcare practices they
were engaging in.

The most compelling event during this time involved
the Ellis Island Immigration Museum, part of the Statue of Liberty National
Monument. I was approached by one of the museum’s directors, who wanted to
feature Alternative Medicine: The Definitive Guide in an exhibit named,
“Immigrant Health Traditions.” In many ways, alternative medicine was largely
synonymous with the forms of traditional medicine brought to the US by
immigrants. We discussed how homeopathy, naturopathy, water therapy,
herbal medicine, had come to the US via European immigrants, acupuncture and
Ayurveda from China and India.

Our book was featured on a
large bookstand in a central location in the exhibit. The exhibit proved to be
the most popular exhibit in recent memory. All was going well. Then one day I
received a phone call from the museum’s director. A well-known “quackbuster,”
Dr. Victor Herbert, heard about the display and went to see for himself. He
wrote an angry letter to the Superintendent of the Statue of Liberty National
Monument demanding that the government should not been seen as promoting a book
about unorthodox and potentially dangerous health practices, and that the book
should be immediately removed from the exhibit. The Superintendent acquiesced
and told the museum that the book must be removed.

We received a copy of Dr. Herbert’s letter
through the Freedom of Information Act and began a campaign to overturn the
Superintendent’s decision. We received considerable media coverage including
the New York Times and Wall Street Journal. Publisher’s Weekly and the Library
Journal spoke of “bookburning” and 1st amendment issues. Of course, Dr.
Herbert’s and the government’s actions only increased the popularity and buzz
about the book.

To date, Alternative Medicine: The Definitive
Guide, which I affectionately refer to as “the 6 pound doorstop”, has sold over
600,000 copies.

Integrator: By the mid 1990s you were working
on a huge project in the emerging internet world with which you are still
involved, HealthWorld Online. Your partner was the first to hang the Integrator name on my work. It’s
outlived Mothernatures.com and a score of other internet start-ups. How do you
explain that?

Strohecker: I think that the power of our original vision and
intent for HealthWorld Online (www.healthy.net)
is responsible for our longevity, as we are about to enter our 14th year
online. We made it through the early “wild west” days of the web, the peak of
Internet expansion and speculation, and the Internet collapse of 2001. And in
the most difficult periods, it was really dedication to the original mission
that got us through. And on January 1, 2010, we are launching a totally
redesigned and restructured site that we anticipate will successfully take us
on the next leg of our journey.

After Alternative Medicine: The Definitive
Guide had been successfully launched in the marketplace, I was looking for
the next step, a way to move beyond the limitations presented by a 6 pound,
1100 page book, painstakingly typeset in Quark, with hundreds of contributors.
It wasn’t practical to make the book available to people who could benefit from
it worldwide, and it would probably be impractical to update the book for 8 or
10 years. Instead of a 1100 page book, wouldn’t it be great to be able to have
people access thousands of expert articles, resources, practitioner referrals,
calendar of events, and real time updates on key legislation affecting the
practice of and access to alternative medicine on a federal and state level?
Then,
one day in the Fall of 1994, my nephew told me about an intriguing government
system of interconnected computer networks known as the Internet. About the
same time, I met a visionary businessman who asked me, “If you could do
anything right now, what would you do?” In my reply and our subsequent
discussion, the vision for a new online health and wellness network was born.
Shortly thereafter, we created HealthWorld Online and started work on the
world’s first major health site focused on alternative medicine, wellness and
self-care.

The first online portal for alternative medicine and wellness

Our primary vision for the company was to create
an online consumer-oriented “health world” which could provide potentially
life-saving alternative choices and solutions to people worldwide, to help
prevent unnecessary human suffering. Secondarily, we wanted to use this new
online medium to help organize the disparate fields of alternative medicine and
their leading experts and organizations, in one virtual environment. This organized
field of alternative medicine would interface with the complementary fields of
wellness and fitness, to provide a powerful model of health. We referred to
this coming together of parallel fields as creating a system of “WellCare” that
could interface with the current “Healthcare” (SickCare) system, to form a more
comprehensive system of “Integrated Health”.

The project of creating HealthWorld Online was
even more collaborative, passionate and exciting than creating the Alternative
Medicine book, as the alternative medicine community had the ability to
participate in an emerging, revolutionary medium that had the potential giving
the community a quantum push into the future, with the possibility of reaching
hundreds of million people worldwide. At the same time, it was a new, unknown
and unpredictable new medium. We worked closely with the community,
particularly with the professional associations. In an effort to support
getting the alternative medicine community represented on the web, we built 45
pro-bono web sites for professional associations, trade associations,
educational institutes and consumer health organizations.

We realized that we had the ability to create a
virtual health world, a “health village,” where people who were looking for a
solution to a health concern or looking for a higher level of health and
wellness could navigate down a range of pathways to explore a deep and broad
reservoir of expert information, resources, and services.

After 15 months of intensive development, our
site, www.healthy.net, was launched with
over 20,000 pages of expert content (unheard of on the web at the time), some
two years before WebMD. We offered the first practitioner referral network
representing nearly 20 alternative medicine modalities, the first online global
health calendar, and the first worldwide free access to Medline, for both
consumers and professionals.

We quickly learned the
challenges of pioneers and early adapters, as no one had any real idea of what
would work and what would not in this emerging medium. Some of our ideas worked
beautifully and succeeded. Other “great” ideas met with a surprising and
resounding thud once they went live. It was too early on the web for anyone to
be an expert, and there were really no consultants. We were on our own. We
needed to constantly be creative and adapt.

And now, as we launch our newly redesigned site,
we find ourselves moving into a stronger focus on wellness and healthy living.
With the growing acceptance of CAM practices and the movement towards
Integrative Health or Integrative Medicine, we feel that “alternative medicine”
has both evolved into a more coherent field and that is becoming more deeply
integrated into our overall culture, we feel that the new frontier is personal
wellness – what the individual is able and willing to do maintain their overall
health and wellbeing.

Integrator: You have shared that the culture
in which you were operating had begun to change by the mid-1990s. Could you
comment on that.

Strohecker: As I mentioned previously, the environment in the early
1990s was very hostile, on all fronts, to what we then called alternative
medicine. Consumers were still suspicious and mistrustful, often ridiculing
family members, friends or associates who received alternative treatments, took
supplements or herbs, or meditated or practiced yoga. Then, the tide slowly
began to turn with the creation of the Office of Alternative Medicine in the
early 1990s, passage of DSHEA, the release of our book, Alternative Medicine:
The Definitive Guide, the launching of HealthWorld Online, the diligence of
tens of thousands of practitioners of “alternative” modalities, a host of other
related factors.





There was a stronger embrace by consumers, more
openness from conventional practitioners, the government and the media. But, at
the same time there seemed to be a stiffening of resistance and opposition in
some quarters. It was really a crack in the door. And over the last 15 years,
the crack has grown much larger.

Integrator: In the last
couple years the site and your own work have focused significantly on a
wellness focus rather than alternative medicine or integrative medicine or any
combination of the above. What’s the fit? Do you think wellness is as imbedded
in CAM practices as the practitioners tend to say that it is?

Strohecker: There
is a strong and inherent fit. Long before I developed an interest in
alternative medicine, I was focused on how we create a higher level of personal
wellbeing. I was always exploring how we can maximize our potential as human
beings. At the same time, I was fascinated with natural approaches to
re-establishing balance and harmony in body, mind and spirit when our system is
out of balance and we are unwell. Our original intention in HealthWorld Online
was to incorporate both a strong focus on wellness and self-care in addition to
the best of alternative medicine. Our original model was to have two pathways
in HealthWorld, one pathway if you were looking for a natural solution to a
health concern, and another pathway if you were looking for enhanced health and
wellbeing.

Our
recent 2010 re-launch of HealthWorld and re-branding of the website as
healthy.net is significant in a number of ways. As you indicated in your
question, we have placed much of our focus on bringing our Wellness Inventory
program (www.WellPeople.com) to the
corporate, healthcare, spa, university and coaching markets. The Wellness
Inventory is a holistic assessment and life-balance program designed to help
people to gain personal insight into their state of physical, emotional, and
spiritual wellness. The program then provides guidance and tools to transform
this new awareness into sustainable lifestyle change and a renewed sense of
health and wellbeing. We have also created a certification program to train wellness coaches to support individuals on their personal wellness journey.

Developed by wellness pioneer John Travis MD, MPH

Over the last 4-5 years I felt a strong drive to
help establish an awareness of the wellness paradigm in our culture, alongside
the prevailing disease or treatment paradigm. Together, the two strengthen and
balance each other, creating a foundation for a more complete system of
healthcare, and supporting individuals in taking more responsibility for their
own health and wellbeing.





Today, we are coming full circle and infusing
healthy.net with a stronger wellness focus, fully embracing the wellness
dimension. The site is now cobranded on the page headers with both healthy.net
and Wellness Inventory. The navigation on the new site is much more focused
than before on wellness and healthy living – Healthy Kitchen, Emotional Health,
Healthy Relationships, Healthy Sleep, Mind/Body Health, Healthy Woman, Healthy
Aging, etc, however, the focus on alternative therapies and Integrative
Medicine and key health conditions is still present.

I
have always felt that the practice alternative medicine, CAM and Integrative Medicine
tend to focus too strongly on diagnosis and treatment, and not enough on
self-care and creating wellness. I understand that this is due, in large part,
to trying to fit into the current reimbursement structure and the current style
of practice, which is based on a disease model. However, I believe the time is
right to begin to shift to a model of healthcare that incorporates wellness as
the fundamental entry point to the healthcare system. Only a focus on personal
responsibility, wellness, and healthy lifestyle choices will begin to shift the
health of our nation. No amount of treatment alone, even the most enlightened,
natural, non-invasive treatments will turn the tide.

This is where the public and private sectors,
Wall Street to Main Street, Madison Avenue to the Washington, DC, board rooms
to grass roots activists, need to become involved to help support what Senator
Harkin calls a ”Wellness Society”, and what I like to call a “Culture of
Wellness”. As we saw in the testimony from Drs. Andrew Weil, Mehmet Oz, Dean
Ornish and Mark Hyman, before the Senate HELP Committee back in February of
2009, there are many ways to start moving in that direction from Dr. Oz’ Health
Corps, health coaching, community activism, and simple self-care (Dr. Weil’s opening
remark about breathing exercises as the ultimate and most effective single
self-care practice).

Regarding
the issue of wellness being imbedded in CAM practices, I believe that wellness
is inherent in the philosophy as well as the self-care practices for many CAM
professionals. For this reason, CAM providers can probably more effectively
expand the wellness dimension in their practices than a practitioner with no
CAM or Integrative medicine training. However, in practice, wellness all too
often remains an unexercised or unutilized potential in the interaction with
the patient. Wellness is a personal journey towards a higher level of
wellbeing. Possibly the greatest gift a practitioner can give to a patient is
to inspire and support the patient’s desire to improve their overall level and
health and wellbeing, and thereby improve all aspects of their life. Wellness
is more than providing information and self-care techniques, and it is more
than just prevention. As Senator Barbara Mikulski stated in the same
Integrative Medicine hearings: ”Prevention, or preventing disease, is an
outdated concept. The new concept is creating wellness.”

How do we create wellness? John W. Travis, MD,
MPH, one of the original founders of the wellness movement in the 1970s and
creator of the Wellness Inventory, stated this clearly and eloquently,
“Wellness is a choice…. a decision you make to move toward optimal health.
Wellness is a way of life…. a lifestyle you design to achieve your highest
potential for well-being.” Wellness is driven by the individual. No one can
take that journey for you.

The Illness-Wellness Continuum (above) created
by Dr. Travis in 1972 while he was a resident at Johns Hopkins and working the
US Public Health Service shows the relationship of the Wellness and Treatment
Paradigms, and can further clarify the wellness concept. Moving from the
center to the left shows a progressively worsening state of health. Moving to
the right of center indicates increasing levels of health and well-being.





The Treatment Paradigm can only take an
individual to the neutral point, where the symptoms of disease have been
alleviated. The Wellness Paradigm, utilized at any point on the continuum,
moves one towards ever higher levels of wellbeing. If the Wellness and
Treatment Paradigms can be integrated in healthcare practices of the future we
can support the patient’s personal wellness journey while providing state of
the art integrative health care.

Integrator: You are spending much of your time
now out in a different arena and have been for the last 4 or 5 years, doing
employer and wellness shows in addition to conferences on Integrative Medicine.
Can you comment on the changes you are seeing in those communities? Do you
bring up your past in “alternative medicine”?

Strohecker: After meeting wellness pioneer, Dr. John Travis, in
1996 I realized that he had been 20 years ahead of his time when he established
the world’s first wellness center in 1975 in Mill Valley, CA and created the
Wellness Inventory, the first wellness assessment, as a whole person intake for
the center. And in 1996, I felt he was still ahead of his time, but we started
a dialogue about collaborating on creating an online program based on the Wellness
Inventory. When we launched the program in 2003, the corporate, healthcare and
spa worlds were not ready for a whole person wellness model. There are a number
of reasons this was true.

As
the early wellness movement from the 1970s began to enter the corporate and hospital
market in the 1980s, the emerging wellness programs were mostly based on an
impersonal health risk model using HRAs (health risk appraisals). The
idea was to determine the level of health risk of individual employees, create
interventions to lower the health risks (weight loss programs, smoking
cessation programs, stress management programs, etc), and thereby lower
healthcare costs and insurance premiums. This basic model, which is a disease
model, has predominated until the current time. In this world, prevention and
wellness are largely synonymous, in contrast to Senator Milkulski’s more
enlightened views referenced earlier.

Interestingly, Dr. Travis had been a protégé of
Dr. Lewis Robbins, the creator of the Health Risk Appraisal and had helped
create the first computerized HRA for the CDC. However, he chose to move beyond
the Health Risk Model to create the Wellness Inventory, which operates through
a wellness model, looking at the whole person, and the influences “beneath
the iceberg” that are underlying an individual’s current lifestyle and
behavior.

My interactions at worksite wellness conferences
up until about two years ago, were largely the same. Employers, if that had a wellness
program, were using a program based on health risk and the disease model. “We
already have an HRA, we don’t need anything more for our wellness program,” was
a common refrain. Another common comment was, “We don’t see any value in
wellness coaching.”

Then, things began to shift. I think there were
a number of factors. The consumer wellness revolution continued to grow,
raising awareness among corporate employees and managers. Talks about health
and wellness coaching, Motivational Interviewing, Appreciative Inquiry, Prochaska’s Six Stages of
Change, and Positive Psychology began to appear in the conference programs.
These represent parallel threads in a larger evolution in how we look at
personal change and personal wellbeing.

Today, I am more likely to
hear the following in my conversations with HR directors and others involved in
worksite wellness and hospital program, “We are looking into using wellness
coaches in our wellness program,” “We are looking for something that addresses our
employee’s change readiness,” “I am looking for a more whole person approach to
wellness that embraces body, mind and spirit,” or “We are finding that trying
to coach with the results of an HRA are ineffective.” The conversation has
dramatically changed.





We are finding a much stronger reception to our
Wellness Inventory assessment and life-balance program (www.WellPeople.com) among employers,
hospitals, universities, spas, integrative medicine centers, concierge
practices, as well as individual health practitioners and wellness coaches
worldwide. We are also experiencing growing demand for our Wellness Inventory
Coach Certification Training. We are working with groups in South Africa,
Australia, China, Singapore, Thailand, India, Egypt and other countries. I am
definitely witnessing a worldwide shift in which people and institutions are
beginning to embrace the wellness paradigm. Possibly, this is laying the
foundation upon which we for creating a culture of wellness. But we have
to walk through the door. Maybe thirty-five years after Dr. Travis created the
Wellness Inventory, its time has come.